Provider Relations Representative, Senior

Your Role

The Provider Relations team serves as the intermediary between Blue Shield of California and the IPA/medical groups, hospitals, and PPO physicians in which they are responsible for maintaining long-term relationships with. The Provider Relations Representative, Senior is responsible for building relationships with IPA/medical groups, PPO physicians, and hospitals for all lines of business. This role entails delivering established quantifiable goals and targets for an assigned provider network of providers, and services the designated provider network in operational and compliance aspects of provider contracts. Reporting to the Manager, Provider Services, this role will work with providers and internal constituents to resolve service issues promptly and effectively. The ability to present in group settings and independently drive issues to resolution as well as effective multi-tasking skills that are critical for success.

Your Knowledge and Experience

• Requires a college degree or equivalent experience
• Requires 5 years of prior relevant experience
• Strong organizational and time management skills
• Ability to manage multiple initiatives
• Knowledge of Provider Networks in California
• Appropriate knowledge of delegation and oversight
• Knowledge of regulatory requirements is preferred